| Doctor Name: | BRUCE F SULLENS |
| NPI Number: | 1003990300 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 5601003720 |
| Business Practice Address: | 14700 East Old Us 12 Chelsea, MI - 481181185 |
| Business Phone Number: | 7344751321 |
| Business Fax Number: | |
| Mailing Address: | 3621 S State St, 700 Kms Place ANN ARBOR |
| State: | MI |
| Postal Code: | 48108 |
| Phone Number: | 7349362047 |
| Fax Number: | |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 03/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5601003720 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |